Wellcome Film of the Month: Spot the midwife

The topic of childbirth appears in a large number of the films and videos in the Moving Image & Sound collection of the Wellcome Library (a list below). Although many of the titles show in some detail the process of giving birth, hardly any of these films were destined to be screened to mothers-to-be prior to the 1970s. They were almost exclusively made to show to the medical profession – whether trainee doctors, nurses, midwives or anaesthetists. There are many films that promote the medicalisation of childbirth due to any number of potential complications and the traditional midwife seems to melt away into the background, becoming practically invisible.

Currently airing in the UK on Sunday evenings is the popular BBC TV Series, Call the Midwife, based on the books written by Jennifer Worth. Critical reviews are mixed in terms of its “soft focus”, the nostalgic treatment of the 1950s, and the “schmaltzy” story lines (see Serena Davies’s review in the Telegraph). These comments are despite the depiction of the grittier aspects of living in East London and the series has proved hugely popular with audiences. In Episode 1, set in 1958, there were a number of storylines (wife battering, prostitution on a ship) as well as a story about the use of nitrous oxide (commonly known as laughing gas) for the relief of pain in childbirth. Nitrous oxide alone and in combination with other gases had been used in anaesthesia for some time in surgery and there are several films in our collection that detail this (see The Technique of Anaesthesia series from 1944). The problem with gas used either singly or in combination is that the levels of anaesthesia and analgesia have to be carefully calibrated as overdosing can depress respiration, cause anoxia, heart failure and even death. This meant that the task of administering these agents had to be performed by a specialist.

That brings us to this month’s film, which provides an insight into how the prevailing attitudes to childbirth were changing in the medical profession. Relief of Pain in Childbirth was made by chemical company ICI in 1954. A technical film, it compares the actions of nitrous oxide with ICI’s patented product trichloroethylene (trade name Trilene), which has similar properties and labelled the gas for “perfect childbirth with minimal suffering”. The narrative and simple graphic illustrations explain the action of the gas and are presented in the ‘house style’ typical of these kinds of corporate promotional films, but at 18 minutes long it rather labours the point.

The most interesting aspect of the film is that it features a real mother in labour using pain relief: she is apparently alone, although the midwifery team were probably just out of shot. It would have been interesting to hear their words of encouragement as her labour progressed! The film was made at Guy’s Hospital in London and, no doubt, the production team would have needed to be on stand-by waiting for a woman to go into labour, as we know was the case with the making of another film, The management of twins in pregnancy and labour (1958). Today’s film-makers have similar challenges, according to a recent article in the Radio Times about Call the Midwife: “Mother Nature has no respect for filming schedules,” says screenwriter Heidi Thomas. And Terri Coates, consultant midwife to the series, has to lurk under the bed, just out of shot, in order to make sure that the real babies are not stressed and the scenes are convincing.

Trilene was withdrawn from use in the 1980s due to its toxicity and the development of safer alternatives. But Relief of Pain in Childbirth illustrates the shift in the treatment of women in labour, promoting the ability to self-administer pain relief and the importance of accessing antenatal education, empowering women to know what lies ahead so that they can make informed decisions.

A film by the charity, the Spastics Society (now Scope) looking at the unsatisfactory state of perinatal care in the UK, especially in the way the centralised system de-personalises women, alienating those mothers who are most at risk.

Fascinating list! :-) Also, interesting to see a blog pondering the challenges of filming and communicating medical procedure.

As well as studying Science Communication, I am also an actor who appears in the programme Call the Midwife. Last year I wrote about these filming issues for Imperial College’s science communication blog, Refractive Index. You can find the article here:

I am a very big fan of the Call the Midwife series; I can’t imagine what the medical practioners of the past would have thought if they had any inkling that childbirth could be portrayed in such vivid detail to such popular acclaim. Let’s hope they would be delighted. It’s also pleasing that tv drama programmes consult with the right medical professionals.

I understand a film depicting childbirth was screened to me and my peers when I was about 11. What it failed to say was, that if you are actually giving birth, you don’t have to look (I speak from experience!). Perhaps the popularity of the series relates to this demystification?

I find the films in our collection provide a fascinating insight into medical-science communication. What comes out strongly for me is the tension between the purpose and the message of the piece. Often there is a perceptible earnestness to make genuine progress in healthcare and education.

Many of these films are “hidden” cinema and would have been distributed for professional audiences. The ‘Relief of pain in childbirth’ film actually came from an acquisition of material made by the Nuffield Department of Anaesthetics, Oxford – so I can envisage it was used partly as a training film for the organisation and part as a promotional film for the company.

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